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Contents 42 of 42 results on Saved Results1. Lower limb paralysis from ischaemic neuropathy of the lumbosacral plexus following aorto-iliac procedures.............................. Page 3

2. Sealing zones have a greater influence than iliac anatomy on the occurrence of limb occlusion following endovascularaortic aneurysm repair. ............................................................................................................................................................................................................. Page 3

3. Early graft thrombosis after endovascular aortic aneurysm repair with aortouni-iliac endografts. .................................................... Page 3

4. Predictive factors for limb occlusions after endovascular aneurysm repair. ................................................................................................. Page 4

5. The impact of early pelvic and lower limb reperfusion and attentive peri-operative management on the incidence of spinalcord ischemia during thoracoabdominal aortic aneurysm endovascular repair................................................................................................ Page 4

6. Limb ischemia after EVAR: an effect of the obstructing introducer?................................................................................................................. Page 5

7. Stent-graft limb deployment in the external iliac artery increases the risk of limb occlusion following endovascular AAArepair. ............................................................................................................................................................................................................................................... Page 5

8. A new management for limb graft occlusion after endovascular aneurysm repair adding a vollmar ring stripper: theunclogging technique................................................................................................................................................................................................................. Page 6

9. [Stagewise treatment of a patient with multifocal atherosclerosis, limb ischaemia, and surgical infection]. ................................... Page 6

10. Predicting iliac limb occlusions after bifurcated aortic stent grafting: anatomic and device-related causes. ............................... Page 7

11. Endovascular graft limb occlusion after an anterior resection for rectal cancer: report of a case. .................................................... Page 7

12. A new endovascular approach to treatment of acute iliac limb occlusions of bifurcated aortic stent grafts with anexoskeleton.................................................................................................................................................................................................................................... Page 8

13. Bifurcated aortoiliac endograft limb occlusion during deployment and its bailout conversion using the external iliacartery to internal iliac artery endograft technique........................................................................................................................................................ Page 8

14. Factors Predisposing to Endograft Limb Occlusion after Endovascular Aortic Repair. .......................................................................... Page 8

15. Incidence and treatment results of Endurant endograft occlusion. ................................................................................................................ Page 9

16. Extensive ischemic ulcers due to limb occlusion after endovascular aneurysm repair: a case report. ............................................. Page 9

17. Adjunctive iliac stents reduce the risk of stent-graft limb occlusion following endovascular aneurysm repair with theZenith stent-graft........................................................................................................................................................................................................................ Page 10

18. Sheath-shunt technique for avoiding lower limb ischemia during complex endovascular aneurysm repair. ................................. Page 10

19. Thromboembolic complications during endovascular aneurysm repair. ...................................................................................................... Page 11

20. Regarding "Endograft limb occlusion and stenosis after ANCURE endovascular abdominal aneurysm repair". ......................... Page 11

21. Limb graft occlusion following EVAR: clinical pattern, outcomes and predictive factors of occurrence. ........................................ Page 11

22. Self expandable stent application to prevent limb occlusion in external iliac artery during endovascular aneurysm repair. . Page 11

23. Occlusion of the common and internal iliac arteries for aortoiliac aneurysm repair: experience with the Amplatzervascular plug.................................................................................................................................................................................................................................. Page 12

24. Management of acute type B aortic dissections and acute limb ischemia.................................................................................................... Page 12

25. Current evidence regarding chimney graft occlusions in the endovascular treatment of pararenal aortic pathologies: asystematic review with pooled data analysis. .................................................................................................................................................................. Page 13

26. Strategies that minimize the risk of iliac limb occlusion after EVAR............................................................................................................... Page 13

27. [Lower body ischemia due to bending of the stent after hybrid treatment for chronic stanford type B aortic dissection]. .... Page 13

HDAS ExportSearch Strategy EVAR paper 30 Mar 17 - 11:00

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28. Response to letter to the editor: 'Re: Endograft limb occlusion in EVAR: iliac tortuosity quantified by three differentindices on the basis of pre-operative CTA'......................................................................................................................................................................... Page 14

29. Commentary on: "endograft limb occlusion in EVAR: iliac tortuosity quantified by three different indices on the basis ofpreoperative CTA". ...................................................................................................................................................................................................................... Page 14

30. Re. 'Endograft limb occlusion in EVAR: iliac tortuosity quantified by three different indices on the basis of pre-operativeCTA'. .................................................................................................................................................................................................................................................. Page 14

31. Successful endovascular repair in two cases of graft limb occlusion after endovascular aneurysm repair for abdominalaortic aneurysms. ........................................................................................................................................................................................................................ Page 14

32. Adjunctive primary stenting of Zenith endograft limbs during endovascular abdominal aortic aneurysm repair:implications for limb patency.................................................................................................................................................................................................. Page 15

33. Successful Endovascular Management of Intraoperative Graft Limb Occlusion and Iliac Artery Rupture Occurred duringEndovascular Abdominal Aortic Aneurysm Repair. ...................................................................................................................................................... Page 15

34. Type B aortic dissection after endovascular abdominal aortic aneurysm repair causing endograft collapse and severemalperfusion. ................................................................................................................................................................................................................................ Page 15

35. Ischemic complications after endovascular abdominal aortic aneurysm repair. ....................................................................................... Page 16

36. Contralateral acute lower limb ischaemia following total hip replacement in a patient with an endovascular abdominalaortic aneurysm repair. ............................................................................................................................................................................................................. Page 16

37. Limb occlusion after endovascular repair of abdominal aortic aneurysms with supported endografts. ......................................... Page 17

38. [Occlusion of endovascular stent-graft for abdominal aortic aneurysm three years after surgery].................................................. Page 17

39. Limb occlusion after endovascular repair of an abdominal aortic aneurysm: beware the narrow distal aorta............................. Page 17

40. Endograft limb occlusion and stenosis after ANCURE endovascular abdominal aneurysm repair.................................................... Page 18

41. Endovascular repair of graft limb occlusion after endovascular repair for abdominal aortic aneurysm using 0.014-inchguidewire and coronary balloon............................................................................................................................................................................................ Page 18

42. Endovascular graft limb occlusion. ............................................................................................................................................................................... Page 18

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Results Saved Results42 of 42 saved results

1. Lower limb paralysis from ischaemic neuropathy of the lumbosacral plexus following aorto-iliac procedures.Authors Abdellaoui, Adel; West, Nick J; Tomlinson, Mark A; Thomas, Martin H; Browning, NeilSource Interactive cardiovascular and thoracic surgery; Aug 2007; vol. 6 (no. 4); p. 501-502Publication Date Aug 2007Publication Type(s) Case Reports Journal ArticleDatabase Medline

Available in full text at Interactive Cardiovascular and Thoracic Surgery from Free Access ContentAvailable in full text at Interactive CardioVascular and Thoracic Surgery from Highwire PressAvailable in full text at Interactive Cardiovascular and Thoracic Surgery from Free Access Content

Abstract OBJECTIVESNeurological injuries following aorto-iliac procedures are rare, unpredictable and cause significantmorbidity. We report four cases of lower limb paralysis following aorto-iliac procedures, in which two patientssuffered internal iliac occlusion and discuss potential aetiological factors.METHODSFour male patients, ageranging between 56 and 77 years, underwent aorto-iliac procedures. Three patients underwent repair of infra-renal abdominal aortic aneurysm (2 open and 1 endovascular repair) and one patient had percutaneousangioplasty of the internal iliac artery.RESULTSAll patients developed a unilateral lower limb paralysis earlypost procedure. Neurophysiological studies were performed in three patients and confirmed the injury to thelumbosacral plexus in two cases. MRI scan performed in two patients did not show any abnormality. In two ofthe cases, occlusion of one internal iliac artery was implicated as the cause of lumbo-sacral plexopathy: one withthe coverage of the internal artery origin with the stent, the other due to thrombotic occlusion of common andinternal iliac in arteries after an elective open repair of abdominal aortic aneurysm with a bifurcated graft.Follow up ranged between 2 and 4 months. Only one patient recovered completely; the other three were leftwith permanent disability.CONCLUSIONSIschaemic neuropathy following aorto-iliac intervention, whetheropen or endovascular, remains a rare, unpredictable and devastating complication. When it occurs it is likely toresult in permanent neurological disability. It is important to note that it may be related to internal iliac arterythrombosis.

2. Sealing zones have a greater influence than iliac anatomy on the occurrence of limb occlusion following endovascular aorticaneurysm repair.Authors Daoudal, Anne; Cardon, Alain; Verhoye, Jean-Philippe; Clochard, Elodie; Lucas, Antoine; Kaladji, AdrienSource Vascular; Jun 2016; vol. 24 (no. 3); p. 279-286Publication Date Jun 2016Publication Type(s) Journal ArticleDatabase MedlineAbstract Limb occlusion is a well-known complication following endovascular aortic aneurysm repair (EVAR), and it very

often leads to reoperation. The aim of this study is to identify predictive factors for limb occlusion followingEVAR. Two hundred and twenty-four patients undergoing EVAR between 2004 and 2012 were included in thisretrospective study. Demographics, anatomic, and follow-up data were compared between two groups (with orwithout thrombosis). Preoperative anatomy was analyzed with a dedicated workstation, using the Society ofVascular Surgery reporting standards. Eleven (4.9%) patients presented with a limb occlusion during follow-up(46 ± 12 months). Univariate analyses were first performed to investigate the influence of preoperativevariables on limb occlusion. Then, variables with a p value

Abstract Endovascular repair of aortic aneurysm has become a viable treatment option in selected patients. However,despite the minimally invasive nature ot this treatment a significant incidence of vascular complications hasbeen reported. Here, we report two cases of acute limbs ischemia due to endograft thrombosis in patientstreated with aortouni-iliac devices and we review the etiologic factors related with these events and thetreatment options. We suggest that the presence of atherosclerotic plaques within the outflow arteries andcoexistent infrainguinal arterial occlusive disease (poor runoff) is an underestimated factor in the risk of graftthrombosis, especially in patients treated with aortouni-iliac devices and we advocate the use in the earlyfollow-up surveillance after endovascular repair of aortic aneurysm of noninvasive test such duplex scanning,segmental pressures and ankle-brachial indices to asses the presence or progress of coexistent occlusivedisease. We also suggest that some adverse outcomes ascribed to device failure might be more properlycharged to inappropriate patient selection.

4. Predictive factors for limb occlusions after endovascular aneurysm repair.Authors Faure, Elsa M; Becquemin, Jean-Pierre; Cochennec, Frédéric; ENGAGE collaboratorsSource Journal of vascular surgery; May 2015; vol. 61 (no. 5); p. 1138Publication Date May 2015Publication Type(s) Journal Article ReviewDatabase Medline

Available in full text at Journal of Vascular Surgery from ElsevierAbstract OBJECTIVEGreater flexibility and smaller sizes for introducer sheaths in the newest stent grafts increase the

feasibility of endovascular aneurysm repair but raise concerns about long-term limb patency. The aim of thestudy was to determine the incidence of and predictive factors for limb occlusion after use of the Endurantstent graft (Medtronic Inc, Minneapolis, Minn) for abdominal aortic aneurysm.METHODSThe Endurant StentGraft Natural Selection Global Postmarket Registry (ENGAGE) prospectively included 1143 patients treatedwith bifurcated devices who were observed for up to 2 years. Limb occlusions were evidenced by computedtomography, angiography, or ultrasound. To predict stent graft limb occlusion, a two-step model-buildingtechnique was applied. We first identified predictors from a total of 47 covariates obtained at baseline and inthe periprocedural period. Subsequently, we reduced the set of potential predictors to key factors that areclinically meaningful. To handle large numbers of covariates, we used the Classification And Regression Tree(CART) method.RESULTSForty-two stent graft limbs occluded in 39 patients (3.4% of the patients). At 2 years,the rate of freedom from stent graft limb occlusion calculated by Kaplan-Meier plot was 97.9% (standard error[SE], 0.33%). Of the 42 occlusions, 13 (31%) were observed within 30 days and 30 (71%) within 6 months. Thestrongest independent predictors were distal landing zone on the external iliac artery, external iliac arterydiameter ≤10 mm, and kinking. High-risk vs low-risk patients were identified according to a decision tree basedon the strongest predictors. Freedom from stent graft limb occlusion was 96.1% (SE, 0.64%) in high-riskpatients vs 99.6% (SE, 0.19%) in low-risk patients.CONCLUSIONSAfter Endurant stent grafting, the incidenceof limb occlusion was low. Classifying patients as high risk vs low risk according to the algorithm used in thisstudy may help define specific strategies to prevent limb occlusion and improve the overall results ofendovascular aneurysm repair using the latest generation of stent grafts.

5. The impact of early pelvic and lower limb reperfusion and attentive peri-operative management on the incidence of spinalcord ischemia during thoracoabdominal aortic aneurysm endovascular repair.Authors Maurel, B; Delclaux, N; Sobocinski, J; Hertault, A; Martin-Gonzalez, T; Moussa, M; Spear, R; Le Roux, M; Azzaoui,

R; Tyrrell, M; Haulon, SSource European journal of vascular and endovascular surgery : the official journal of the European Society for

Vascular Surgery; Mar 2015; vol. 49 (no. 3); p. 248-254Publication Date Mar 2015Publication Type(s) Multicenter Study Journal ArticleDatabase Medline

Available in full text at European Journal of Vascular and Endovascular Surgery from Elsevier


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http://linker.worldcat.org/?rft.institution_id=129905&spage=1138&pkgName=ckjournalathens&issn=0741-5214&linkclass=to_article&jKey=07415214&issue=5&provider=elsevier&date=2015-05&aulast=Faure%2C+Elsa+M%3B+Becquemin%2C+Jean-Pierre%3B+Cochennec%2C+Fr%C3%83%C2%A9d%C3%83%C2%A9ric%3B+ENGAGE+collaborators&atitle=Predictive+factors+for+limb+occlusions+after+endovascular+aneurysm+repair.&title=Journal+of+Vascular+Surgery&rft.content=fulltext%2Cprint&linkScheme=ckeyathens&jHome=https%3A%2F%2Fauth.elsevier.com%2FShibAuth%2FinstitutionLogin%3FentityID%3Dhttps%253A%252F%252Fidp.eduserv.org.uk%252Fopenathens%26appReturnURL%3Dhttps%253a%252f%252fwww.clinicalkey.com%252fdura%252fbrowse%252fjournalIssue%252f07415214&volume=61&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=248&pkgName=ckjournalathens&issn=1078-5884&linkclass=to_article&jKey=10785884&issue=3&provider=elsevier&date=2015-03&aulast=Maurel%2C+B%3B+Delclaux%2C+N%3B+Sobocinski%2C+J%3B+Hertault%2C+A%3B+Martin-Gonzalez%2C+T%3B+Moussa%2C+M%3B+Spear%2C+R%3B+Le+Roux%2C+M%3B+Azzaoui%2C+R%3B+Tyrrell%2C+M%3B+Haulon%2C+S&atitle=The+impact+of+early+pelvic+and+lower+limb+reperfusion+and+attentive+peri-operative+management+on+the+incidence+of+spinal+cord+ischemia+during+thoracoabdominal+aortic+aneurysm+endovascular+repair.&title=European+Journal+of+Vascular+and+Endovascular+Surgery&rft.content=fulltext%2Cprint&linkScheme=ckeyathens&jHome=https%3A%2F%2Fauth.elsevier.com%2FShibAuth%2FinstitutionLogin%3FentityID%3Dhttps%253A%252F%252Fidp.eduserv.org.uk%252Fopenathens%26appReturnURL%3Dhttps%253a%252f%252fwww.clinicalkey.com%252fdura%252fbrowse%252fjournalIssue%252f10785884&volume=49&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=best

Abstract OBJECTIVE/BACKGROUNDSpinal cord ischemia (SCI) is a devastating complication following endovascularthoracoabdominal aortic aneurysm (TAAA) repair. In an attempt to reduce its incidence two peri-proceduralchanges were implemented by the authors in January 2010: (i) all large sheaths are withdrawn from the iliacarteries immediately after deploying the central device and before cannulation and branch extension to thevisceral vessels; (ii) the peri-operative protocol has been modified in an attempt to optimize oxygen delivery tothe sensitive cells of the cord (aggressive blood and platelet transfusion, median arterial pressure monitoring>85 mmHg, and systematic cerebrospinal fluid drainage).METHODSBetween October 2004 and December2013, 204 endovascular TAAA repairs were performed using custom made devices manufactured withbranches and fenestrations to maintain visceral vessel perfusion. Data from all of these procedures wereprospectively collected in an electronic database. Early post-operative results in patients treated before (group1, n = 43) and after (group 2, n = 161 patients) implementation of the modified implantation and peri-operativeprotocols were compared.RESULTSPatients in groups 1 and 2 had similar comorbidities (median age at repair70.9 years [range 65.2-77.0 years]), aneurysm characteristics (median diameter 58.5 mm [range 53-65 mm]),and length of procedure (median 190 minutes [range 150-240 minutes]). The 30 day mortality rate was 11.6%in group 1 versus 5.6% in group 2 (p = .09). The SCI rate was 14.0% versus 1.2% (p < .01). If type IV TAAAs wereexcluded from this analysis, the SCI rate was 25.0% (6/24 patients) in group 1 versus 2.1% (2/95 patients) ingroup 2 (p < .01).CONCLUSIONThe early restoration of arterial flow to the pelvis and lower limbs, andaggressive peri-operative management significantly reduces SCI following type I-III TAAA endovascular repair.With the use of these modified protocols, extensive TAAA endovascular repairs are associated with low rates ofSCI.

6. Limb ischemia after EVAR: an effect of the obstructing introducer?Authors Jonsson, Thomas; Larzon, Thomas; Jansson, Kjell; Arfvidsson, Berndt; Norgren, LarsSource Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists;

Dec 2008; vol. 15 (no. 6); p. 695-701Publication Date Dec 2008Publication Type(s) Research Support, Non-u.s. Gov't Comparative Study Journal ArticleDatabase Medline

Available in full text at Journal of Endovascular Therapy from ProQuestAvailable in full text at Journal of Endovascular Therapy from EBSCOhostAvailable in full text at Journal of Endovascular Therapy from EBSCOhost

Abstract PURPOSETo evaluate the splanchnic and limb metabolic effects of open repair (OR) of abdominal aorticaneurysms (AAA) versus endovascular aneurysm repair (EVAR) in a pilot study utilizingmicrodialysis.METHODSNine AAA patients (8 men; mean age 74 years, range 61-85) were treated with EVARand 9 had an OR (5 men; mean age 70 years, range 55-85). In the EVAR cases, which were performedpercutaneously, the external iliac artery was obstructed by the introducer to a mean functional stenosis of 70%(52%-100%). Catheters for microdialysis were placed subcutaneously above the ankle of the right leg and freelyin the abdominal cavity to measure the levels of lactate and pyruvate. The lactate/pyruvate ratio was calculatedas a measure of ischemia. Measurements started at the end of surgery and continued for 2 days. Mean valueswere compared using the Mann-Whitney U test.RESULTSThe mean value of intraperitoneal lactate during thefirst day after EVAR was 1.5+/-0.7 mM versus 2.6+/-0.8 mM after OR (p = 0.019). The lactate/pyruvate ratiowas 10.2+/-2.2 after EVAR and 12.3+/-2.6 after OR (p = 0.113). Leg lactate mean values were 4.2+/-2.0 mMafter EVAR versus 1.8+/-0.6 mM after OR (p

Abstract PURPOSETo assess whether deployment of an endograft limb in the external iliac artery (EIA) increases therate of limb occlusion following endovascular aneurysm repair (EVAR).METHODSInterrogation of aprospectively maintained database identified 661 patients (596 men; median age 73 years, range 37-93) withinfrarenal abdominal aortic aneurysm who underwent EVAR between 1996 and 2010 using Zenith stent-graftspredominately. Of these, 567 patients [56 (9.9%) women] had both endograft limbs deployed in the CIA (1203limbs at risk), while 94 patients [9 (9.6%) women] had at least 1 limb in the EIA (22 bilateral; 116 limbs at risk).An adjunctive bare metal stent was used in 8 (9%) limbs deployed in the EIA.RESULTSThere were 31 limbocclusions, all unilateral: 17 (3%) patients in the CIA group had an occluded limb (1% of limbs at risk) vs. 14(15%) patients in the EIA group (12% of limbs at risk; p

Abstract UNLABELLEDThe authors share herein their experience in successful treatment of a male patient withmultifocal atherosclerosis and lower-limb critical ischaemia complicated by erysipelas.THE AIM OF THEWORKto show not only efficacy of iloprost (Ilomedin) used as conservative treatment in patients presentingwith critical ischaemia and surgical infection in both pre- and postoperative periods in order to save the limb,but also the possibility of postponing reconstructive intervention, improving the patient's quality of life duringthis period, as well as shortening the duration of the postoperative period, and also to demonstrate bothimmediate outcomes of endovascular repair of an abdominal aortic aneurysm and remote results ofcomprehensive treatment for disseminated multifocal atherosclerosis with severe accompanying pathology.

10. Predicting iliac limb occlusions after bifurcated aortic stent grafting: anatomic and device-related causes.Authors Carroccio, Alfio; Faries, Peter L; Morrissey, Nicholas J; Teodorescu, Victoria; Burks, James A; Gravereaux, Edwin

C; Hollier, Larry H; Marin, Michael LSource Journal of vascular surgery; Oct 2002; vol. 36 (no. 4); p. 679-684Publication Date Oct 2002Publication Type(s) Journal ArticleDatabase Medline

Available in full text at Journal of Vascular Surgery from Free Access ContentAvailable in print at North Manchester Hospital Library from JOURNAL OF VASCULAR SURGERYAvailable in print at Royal Oldham Hospital Library from JOURNAL OF VASCULAR SURGERY

Abstract OBJECTIVEGraft limb occlusion may complicate endovascular abdominal aortic aneurysm repair. The preciseetiologic factors that contribute to the development of these graft limb thromboses have not been defined. Weevaluated our experience with bifurcated aortic endografts to determine factors that may predict subsequentlimb thrombosis. The management of the thrombosed limbs and the results after treatment were alsoinvestigated.METHODSDuring a 4-year period, 351 patients with aortic aneurysms underwent treatment withbifurcated endografts (702 graft limbs at risk). These 351 bifurcated devices included AneuRx (Medtronic,Minneapolis, Minn; n = 35), Ancure (Guidant, Menlo Park, Calif; n = 8), Gore (W.L. Gore & Associates, Sunnyvale,Calif; n = 25), Talent (World Medical, Sunrise, Fla; n = 255), Teramed (Teramed, Minneapolis, Minn; n = 10), andVanguard (Boston Scientific Vascular, Natick, Mass; n = 18). Details regarding the type of device, mechanism ofdeployment, and aortoiliac artery anatomy were collected prospectively and analyzed. Graft limbs wereanalyzed for diameter, use of additional endograft iliac extensions, deployment in the external iliac artery, andendograft to vessel oversizing. Follow-up included physical examination, duplex ultrasonography, and spiralcomputed tomographic scans at 1 month, 6 months, and 12 months and annually thereafter. The follow-upperiod ranged from 2 to 54 months, with a mean follow-up period of 20 months.RESULTSTwenty-six of 702limbs (3.7%) had an occlusion develop. The risk of limb thrombosis was associated with a smaller limb diameter.Mean graft limb diameter was 14 mm in the occluded population, and patent limbs had a mean diameter of 16mm. Thrombosis occurred in 16 of 291 limbs (5.5%) that were 14 mm or less and in 10 of 411 limbs (2.4%) thatwere greater than 14 mm (P =.03). Extension of a graft to the external iliac artery was performed in 96 of the702 limbs. Eight of these 96 limbs (8.3%) had thrombosis develop as compared with 18 of 606 (3.0%) thatextended to the common iliac artery (P =.01). No significant association was present between limb thrombosisand the contralateral or ipsilateral side of a device, the configuration of the iliac graft limb end (closed web, openweb, or bare spring), or the degree of iliac graft limb oversizing. AneuRx, Ancure, Vanguard, and Talent graftseach sustained limb occlusions, with no occlusions seen among the Gore and Teramed devices. No significantincreased risk of graft limb thrombosis was observed in unsupported grafts (1/16; 6.3%) versus supportedgrafts (25/686; 3.6%; P = not significant). Thromboses occurred between 1 day and 23 months after surgery.Thirteen of the 26 thromboses (50%) occurred within 30 days of surgery. Presenting symptoms were mild tomoderate claudication in eight patients (30.8%), severe claudication in 16 patient (61.5%), and paresthesia andrest pain in two patients (7.7%). Eighteen of 26 patients (69.2%) eventually needed intervention to reestablishflow to the occluded limb, including thrombolysis and stenting in two patients (7.7%), axillary femoral bypass inone patient (3.8%), femoral-femoral bypass in 13 patients (50.0%), and axillary-bifemoral bypass in two patients(7.7%). All patients with mild to moderate symptoms under observation had improvement in symptoms with nofurther interventions necessary. All revascularizations were successful in relievingsymptoms.CONCLUSIONGraft limb occlusion is a recognized complication of endovascular treatment ofabdominal aortic aneurysms that may be associated with smaller graft limb diameter and extension to theexternal iliac artery. Occlusions usually necessitate additional intervention for resolution of ischemicsymptoms. The use of small diameter grafts should be avoided when possible to reduce the risk of graft limbocclusions.

11. Endovascular graft limb occlusion after an anterior resection for rectal cancer: report of a case.Authors Hockings, Alexandra; Ooi, Sue Min; Mwipatayi, B P; Sieunarine, KSource Surgery today; 2007; vol. 37 (no. 7); p. 600-603Publication Date 2007Publication Type(s) Case Reports Journal ArticleDatabase Medline


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http://linker.worldcat.org/?jHome=http%3A%2F%2Fwww.sciencedirect.com%2Fscience%2Fjournal%2F07415214&linktype=besthttp://linker.worldcat.org/?jHome=http%3A%2F%2Fwww.hlisd.org%2FLibraryDetail.aspx%3Flibraryid%3D3397&linktype=besthttp://linker.worldcat.org/?jHome=http%3A%2F%2Fwww.hlisd.org%2FLibraryDetail.aspx%3Flibraryid%3D4072&linktype=best

Available in full text at Surgery Today from EBSCOhostAbstract An endovascular aneurysm repair has become an important therapeutic option for the management of patients

with aortic aneurysms. Early advantages of the endovascular technique have been well documented. Patientswith aortic aneurysms undergoing these procedures are usually elderly, which increases the likelihood ofcomorbidities. With the increased use of vascular devices, potential complications such as graft limb occlusionneed to be widely understood, so they can be recognized and treated early. We recently treated an 85-year-oldman with acute endovascular graft limb occlusion after an elective anterior resection for rectal cancer, and wediscuss some factors that may have contributed to this complication.

12. A new endovascular approach to treatment of acute iliac limb occlusions of bifurcated aortic stent grafts with anexoskeleton.Authors Milner, Ross; Golden, Michael A; Velazquez, Omaida C; Fairman, Ronald MSource Journal of vascular surgery; Jun 2003; vol. 37 (no. 6); p. 1329-1331Publication Date Jun 2003Publication Type(s) Case Reports Journal ArticleDatabase Medline

Available in full text at Journal of Vascular Surgery from Free Access ContentAvailable in print at North Manchester Hospital Library from JOURNAL OF VASCULAR SURGERY

Abstract Endovascular aneurysm repair continues to become increasingly popular. As the number of implantedendografts increases, complications will increase as well. We report a new approach to endovascular treatmentin two patients with acute iliac limb occlusions of a bifurcated aortic endograft with an endoskeleton. Neitherpatient required femoral-femoral bypass grafting because of unilateral limb ischemia. We believe this is theoptimal primary approach in patients with a bifurcated stent graft with an endoskeleton.

13. Bifurcated aortoiliac endograft limb occlusion during deployment and its bailout conversion using the external iliac artery tointernal iliac artery endograft technique.Authors Kehagias, Elias; Kontopodis, Nikolaos; Tsetis, Dimitrios; Ioannou, Christos VSource Annals of vascular surgery; Jul 2015; vol. 29 (no. 5); p. 1029-1034Publication Date Jul 2015Publication Type(s) Case Reports Journal ArticleDatabase Medline

Available in full text at Annals of Vascular Surgery from ElsevierAbstract Endovascular aneurysm repair has become the preferred method to treat abdominal aortic aneurysms (AAAs).

The Ovation TriVascular Stent-Graft system introduces a unique concept of separation of the metal (stent) andfabric (graft) portion of the endograft's main body to facilitate delivery through ultra-low profile 14F devices. Inthe setting of a narrow distal aneurysmal lumen, usually due to the presence of thrombus, deployment of thisendograft may be complicated by folding and collapse of the (unsupported by a stent) aortic body or limbs,making catheterization and ballooning impossible. We present a case of Ovation endograft contralateral limbcollapse in a tight AAA lumen due to thrombus deposition, which led to folding and total occlusion of the limband made limb catheterization impossible. This is a real-life example of how the external iliac artery to internaliliac artery endograft technique may be used as a bailout procedure, converting the procedure into an aortouni-iliac graft. To our knowledge, this is the first reported bailout use of this technique in English literature whichmay be used in selected cases.

14. Factors Predisposing to Endograft Limb Occlusion after Endovascular Aortic Repair.Authors Mantas, G K; Antonopoulos, C N; Sfyroeras, G S; Moulakakis, K G; Kakisis, J D; Mylonas, S N; Liapis, C DSource European journal of vascular and endovascular surgery : the official journal of the European Society for

Vascular Surgery; Jan 2015; vol. 49 (no. 1); p. 39-44Publication Date Jan 2015Publication Type(s) Journal ArticleDatabase Medline



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Abstract OBJECTIVESThe aim of this study was to investigate risk factors for endograft limb occlusion afterendovascular abdominal aneurysm repair (EVAR), using a case control design.METHODSAll patients presentingwith endograft limb occlusion after elective EVAR between January 2010 and June 2013, along with age, sex,and type of endograft matched controls were included in the study. The impact of atherosclerotic risk factors,anatomic characteristics of the aneurysm, procedural details, and antiplatelet therapy was investigated.Multivariate logistic regression analysis and conditional logistic regression analysis for 1:3 matched pairsderiving adjusted odds ratios (ORs) with 95% confidence intervals (CIs) in order to detect significant risk factorsfor endograft limb occlusion among cases and controls were modeled.RESULTSOf the 439 patients treated byEVAR, 18 patients (4.1%) presented with endograft limb occlusion. These patients were compared to 54matched controls. Limb occlusion was associated with iliac artery angulation ≥ 60° (OR = 5.76, 95% CI=1.24-26.74; p = .03) or perimeter calcification ≥ 50% (OR =5.87, 95% CI = 1.10-31.32; p = .04). Limb occlusionwas also associated with ≥ 15% endograft oversizing in the common iliac artery (OR = 5.54, 95% CI =1.11-27.60; p = .04). No other risk factors for limb occlusion were recognized.CONCLUSIONSThe presence ofsignificant angulation and calcification of the iliac arteries as well as excessive limb oversizing appear to beindependent predictors of endograft limb occlusion after EVAR.

15. Incidence and treatment results of Endurant endograft occlusion.Authors van Zeggeren, Laura; Bastos Gonçalves, Frederico; van Herwaarden, Joost A; Zandvoort, Herman J A; Werson,

Debora A B; Vos, Jan-Albert; Moll, Frans L; Verhagen, Hence J; de Vries, Jean-Paul P MSource Journal of vascular surgery; May 2013; vol. 57 (no. 5); p. 1246Publication Date May 2013Publication Type(s) Multicenter Study Journal ArticleDatabase Medline

Available in full text at Journal of Vascular Surgery from ElsevierAvailable in full text at Journal of Vascular Surgery from Free Access Content

Abstract OBJECTIVEThe Endurant endograft (Medtronic Inc, Minneapolis, Minn) is a new-generation device specificallydeveloped to perform well in complex abdominal aortic aneurysm anatomy. Previous reports on the 1- and2-year results of endovascular aneurysm repair (EVAR) with the Endurant endograft showed excellentoutcome, including prevention of migration and type I endoleaks, but occurrence and outcome of post-EVARocclusion have not been determined in a large multicenter patient cohort with midterm follow-up, which is theobjective of this study.METHODSData of consecutive patients treated with the Endurant from December 2007to April 2012 in three Dutch tertiary vascular referral hospitals were prospectively gathered andretrospectively analyzed. Follow-up consisted of regular office visits, computed tomography angiography at 1and 12 months after EVAR, and subsequently, duplex ultrasound imaging or computed tomography angiographyat regular intervals. Patients with ruptured aneurysms or with earlier abdominal aortic surgery were excluded.The incidence and clinical outcome of endograft occlusions were analyzed. An expert review board assessed allcases in the search for possible causes of occlusion.RESULTSIncluded were 496 patients (87.7% male), whowere a median age of 74 years (range, 68-78 years). Median follow-up was 1.7 years (range, 0-4.6 years).Twenty graft occlusions (4.0%) occurred during follow-up. Median time between primary EVAR and detectionof the occlusion was 1 month, with 55% occurring ≤ 60 postoperative days and 90% ≤ 1 year. No associationwas found between occlusion and sex (P = .28), age (P = .96), or use of an aortouniiliac device (P = .66). Technicalerror was the considered cause of the occlusion in 12 patients (60%). The estimated freedom from occlusionwas 98.4% at 30 days, 95.7% at 1 year, and 95.3% at 3 years. Presenting symptoms of occlusion were acute limbischemia in 50%. Treatment was surgical (75%) or percutaneous (25%). Successful revascularization wasachieved in 17 of 20 patients, but reocclusions occurred in five, resulting in a transfemoral amputation in onepatient. Occlusion-related mortality was 0.6% (3 of 496).CONCLUSIONSAt a median follow-up of 1.7 years,Endurant endograft occlusion occurred in 4.0% of 496 patients. Most occlusions occurred ≤ 2 months afterEVAR, and rarely after 1 year. A technical justification for occlusion could be found for 60% of patients. A moreliberal intraoperative and early postoperative (re)intervention strategy may reduce the occlusion rates andimprove outcome.

16. Extensive ischemic ulcers due to limb occlusion after endovascular aneurysm repair: a case report.Authors Kadoya, Yoshito; Kenzaka, Tsuneaki; Naito, DaisukeSource SpringerPlus; 2016; vol. 5 (no. 1); p. 782Publication Date 2016Publication Type(s) Journal ArticleDatabase Medline

Available in full text at SpringerPlus from BioMed CentralAvailable in full text at SpringerPlus from Directory of Open Access JournalsAvailable in full text at SpringerPlus from National Library of Medicine


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Abstract INTRODUCTIONLimb occlusion after endovascular aneurysm repair (EVAR) is a well-known complication.However, extensive ischemic ulcers due to limb occlusion are extremely rare.CASE DESCRIPTIONWe report arare case of extensive ischemic ulcers that developed seven months after EVAR in an 85-year-old Japaneseman. He had been taking appropriate anticoagulant therapy because of paroxysmal atrial fibrillation.Angiography showed a left limb occlusion and superficial femoral artery (SFA) chronic total occlusion (CTO), andintravascular ultrasound showed limb kinking. Endovascular therapy (EVT) was performed, and stent placementwas used to cover a large amount of thrombi and correct the limb kinking, leading to complete recovery of leftlimb blood flow. After additional EVT was performed for the SFA CTO, outflow improved and the ulcers healedcompletely.DISCUSSION AND EVALUATIONIt seemed that the combination of poor inflow and poor outflowled to limb thrombosis.CONCLUSIONSHere, we describe an extremely rare case of extensive ischemic ulcersdue to limb occlusion after EVAR. Patients should undergo careful follow-up after EVAR to monitor blood flowto the lower extremities. Additionally, the early detection and correction of limb kinking and poor outflow areessential to prevent the development of ischemic ulcers.

17. Adjunctive iliac stents reduce the risk of stent-graft limb occlusion following endovascular aneurysm repair with the Zenithstent-graft.Authors Oshin, Olufemi A; Fisher, Robert K; Williams, Leith A; Brennan, John A; Gilling-Smith, Geoffrey L; Vallabhaneni,

S Rao; McWilliams, Richard GSource Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists; Feb

2010; vol. 17 (no. 1); p. 108-114Publication Date Feb 2010Publication Type(s) Journal ArticleDatabase Medline


Abstract PURPOSETo determine whether the introduction of a policy of adjunctive stent insertion based onpreoperative CT assessment or completion angiography reduced the incidence of limb occlusion after stent-graft implantation for endovascular aneurysm repair (EVAR).METHODSA tertiary referral unit's endovasculardatabase was retrospectively interrogated to compare the incidence of endograft limb occlusion in Zenithgrafts following the introduction of a policy of selective adjunctive stent insertion. Group A included 288 limbsat risk in 146 patients (134 men; mean age 74+/-8 years) treated prior to August 2005 in whom adjunctivestents were inserted on an ad hoc basis only. Group B included 293 limbs at risk in 149 patients (127 men; meanage 76+/-7 years) treated after this date in whom a more aggressive adjunctive stenting strategy was adopted.Kaplan-Meier analysis was employed to compare outcomes.RESULTSIn total, 295 patients underwent EVARinvolving 581 iliac vessels, of which 11 (1.8%) occluded at a median of 24 months (0-27). Of 65 limbs extendedinto the external iliac segment, 5 (7.6%) subsequently occluded; in the remaining 516 limbs, there were 6 (1.1%)occlusions (p = 0.004). Across the study group, 38 (6.5%) adjunctive stents were deployed in limbs deemed atrisk; 1 (2.6%) of these occluded. In the remaining 543 unstented limbs, 10 (1.8%) occlusions occurred (p = 0.15).There were 11 occlusions in group A, in which 5 (1.7%) adjunctive stents had been deployed, but none in groupB, which had received 33 (11.2%) stents (p

19. Thromboembolic complications during endovascular aneurysm repair.Authors Thompson, M M; Smith, J L; Bell, P RSource Seminars in vascular surgery; Sep 1999; vol. 12 (no. 3); p. 215-219Publication Date Sep 1999Publication Type(s) Research Support, Non-u.s. Gov't Journal ArticleDatabase MedlineAbstract Thromboembolic complications are relatively uncommon after conventional aneurysm surgery but have been

reported in many early series of endovascular aneurysm repair. This article reviews the clinical evidence forembolization during endoluminal procedures and presents an ultrasound-based method to detect lower limbembolization during aneurysm repair. The results of a comparative clinical trial are presented thatdemonstrated a higher incidence of particulate embolization during endovascular as compared withconventional aneurysm surgery. The implications of this finding for clinical practice are discussed.

20. Regarding "Endograft limb occlusion and stenosis after ANCURE endovascular abdominal aneurysm repair".Authors Kasirajan, Karthikeshwar; Matteson, Brian; Marek, John; Langsfeld, MarkSource Journal of vascular surgery; Oct 2002; vol. 36 (no. 4); p. 869Publication Date Oct 2002Publication Type(s) Letter CommentDatabase Medline

Available in full text at Journal of Vascular Surgery from Free Access ContentAvailable in print at North Manchester Hospital Library from JOURNAL OF VASCULAR SURGERYAvailable in print at Royal Oldham Hospital Library from JOURNAL OF VASCULAR SURGERY

21. Limb graft occlusion following EVAR: clinical pattern, outcomes and predictive factors of occurrence.Authors Cochennec, F; Becquemin, J P; Desgranges, P; Allaire, E; Kobeiter, H; Roudot-Thoraval, FSource European journal of vascular and endovascular surgery : the official journal of the European Society for

Vascular Surgery; Jul 2007; vol. 34 (no. 1); p. 59-65Publication Date Jul 2007Publication Type(s) Journal ArticleDatabase Medline

Available in full text at European Journal of Vascular and Endovascular Surgery from ElsevierAbstract INTRODUCTIONWe reviewed our experience with limb occlusion after EVAR in order (1) to assess the clinical

pattern and treatment options (2) to assess outcomes and (3) to identify predictive factors ofoccurrence.MATERIALS AND METHODBetween 1995 and 2005, 460 AAA patients were electively treatedwith a variety of commercially available stent grafts. There were 369 bifurcated and 91 aortouniiliac grafts (829limbs). Follow-up included physical examination, plain X-ray, Duplex ultrasonography, and spiral computedtomographic scans at 1, 6, 12 months and annually thereafter. All pertinent data were collected prospectivelyand analysed retrospectively. The follow-up period ranged from Day 0 to 104 months, with a median follow-upof 23.4 months.RESULTS36 limbs in 33 patients (7.2%) occluded between Day 0 and 71 months (average: 9.5months) after EVAR. Presentation was acute ischemia in 11 cases, rest pain in 9, claudication in ten. Fourocclusions remained asymptomatic and two occurred intraoperatively. Treatment was femoro-femoral cross-over graft in 19 cases, axillo-femoral bypass in three, thrombectomy and stent in three, thrombolysis and stentin nine, and conservative in two. One patient (3%) died of multiple organ failure after thrombolysis. There wasno amputation. Reocclusions occurred in two patients (6.1%). Multivariate logistic regression showed thatkinking (odds ratio [OR] 11.9; confidence interval [CI] 3.39-42.1; p=0.0001), first graft generation (OR 2.87; CI1.25-6.62; p=0.017) and younger age (OR 1.05; CI 1.00-1.09; p=0.034) were independently related to theoccurrence of graft limb occlusion.CONCLUSIONAcute graft limb occlusion is not rare after EVAR. Thefrequency of limb occlusion has declined with current stent grafts generation. Although surgery andendovascular treatments are efficient and safe, development of a graft limb kink should lead to aggressive pre-emptive treatment to prevent occlusion.

22. Self expandable stent application to prevent limb occlusion in external iliac artery during endovascular aneurysm repair.Authors Lee, Jae Hoon; Park, Ki HyukSource Annals of surgical treatment and research; Sep 2016; vol. 91 (no. 3); p. 139-144Publication Date Sep 2016Publication Type(s) Journal ArticleDatabase Medline

Available in full text at Annals of Surgical Treatment and Research from National Library of MedicineAvailable in full text at Annals of Surgical Treatment and Research from National Library of MedicineAvailable in full text at Annals of Surgical Treatment and Research from National Library of MedicineAvailable in full text at Annals of Surgical Treatment and Research from National Library of Medicine


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http://linker.worldcat.org/?jHome=http%3A%2F%2Fwww.sciencedirect.com%2Fscience%2Fjournal%2F07415214&linktype=besthttp://linker.worldcat.org/?jHome=http%3A%2F%2Fwww.hlisd.org%2FLibraryDetail.aspx%3Flibraryid%3D3397&linktype=besthttp://linker.worldcat.org/?jHome=http%3A%2F%2Fwww.hlisd.org%2FLibraryDetail.aspx%3Flibraryid%3D4072&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=59&pkgName=ckjournalathens&issn=1078-5884&linkclass=to_article&jKey=10785884&issue=1&provider=elsevier&date=2007-07&aulast=Cochennec%2C+F%3B+Becquemin%2C+J+P%3B+Desgranges%2C+P%3B+Allaire%2C+E%3B+Kobeiter%2C+H%3B+Roudot-Thoraval%2C+F&atitle=Limb+graft+occlusion+following+EVAR%3A+clinical+pattern%2C+outcomes+and+predictive+factors+of+occurrence.&title=European+Journal+of+Vascular+and+Endovascular+Surgery&rft.content=fulltext%2Cprint&linkScheme=ckeyathens&jHome=https%3A%2F%2Fauth.elsevier.com%2FShibAuth%2FinstitutionLogin%3FentityID%3Dhttps%253A%252F%252Fidp.eduserv.org.uk%252Fopenathens%26appReturnURL%3Dhttps%253a%252f%252fwww.clinicalkey.com%252fdura%252fbrowse%252fjournalIssue%252f10785884&volume=34&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=139&pkgName=PubMedCentralFT&issn=2288-6575&linkclass=to_article&jKey=101622895&issue=3&provider=NLM&date=2016-09&aulast=Lee%2C+Jae+Hoon%3B+Park%2C+Ki+Hyuk&atitle=Self+expandable+stent+application+to+prevent+limb+occlusion+in+external+iliac+artery+during+endovascular+aneurysm+repair.&title=Annals+of+Surgical+Treatment+and+Research&rft.content=fulltext%2Cprint&eissn=2288-6796&linkScheme=pmc&jHome=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Fjournals%2F2343&volume=91&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=139&pkgName=UKPMC&issn=2288-6575&linkclass=to_article&jKey=2422&issue=3&provider=NLM&date=2016-09&aulast=Lee%2C+Jae+Hoon%3B+Park%2C+Ki+Hyuk&atitle=Self+expandable+stent+application+to+prevent+limb+occlusion+in+external+iliac+artery+during+endovascular+aneurysm+repair.&title=Annals+of+Surgical+Treatment+and+Research&rft.content=fulltext%2Cprint&eissn=2288-6796&linkScheme=epmc&jHome=http%3A%2F%2Feuropepmc.org%2Fjournals%2F2422&volume=91&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=139&pkgName=UKPMCFT&issn=2288-6575&linkclass=to_article&jKey=2422&issue=3&provider=NLM&date=2016-09&aulast=Lee%2C+Jae+Hoon%3B+Park%2C+Ki+Hyuk&atitle=Self+expandable+stent+application+to+prevent+limb+occlusion+in+external+iliac+artery+during+endovascular+aneurysm+repair.&title=Annals+of+Surgical+Treatment+and+Research&rft.content=fulltext%2Cprint&eissn=2288-6796&linkScheme=epmc&jHome=http%3A%2F%2Feuropepmc.org%2Fjournals%2F2422&volume=91&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=139&pkgName=PubMedCentral&issn=2288-6575&linkclass=to_article&jKey=101622895&issue=3&provider=NLM&date=2016-09&aulast=Lee%2C+Jae+Hoon%3B+Park%2C+Ki+Hyuk&atitle=Self+expandable+stent+application+to+prevent+limb+occlusion+in+external+iliac+artery+during+endovascular+aneurysm+repair.&title=Annals+of+Surgical+Treatment+and+Research&rft.content=fulltext%2Cprint&eissn=2288-6796&linkScheme=pmc&jHome=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Fjournals%2F2343&volume=91&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=best

Abstract PURPOSEIliac extension of stent-graft during endovascular aneurysm repair (EVAR) increases the incidence oflimb occlusion (LO). Hypothetically, adjunctive iliac stent (AIS) could offer some additional protection toovercome this anatomic hostility. But still there is no consensus in terms of effective stent characteristics orconfiguration. We retrospectively reviewed our center's experience to offer a possible answer to thisquestion.METHODSOur study included 30 patients (38 limbs) with AIS placed in the external iliac artery (EIA)from January 2010 to December 2013. We classified iliac tortuosity based on anatomic characteristics. AIS'swere deployed in EIA with a minimum 5-mm stick-out configuration from the distal edge of the stent-graft.RESULTSAccording to the iliac artery tortuosity index, grade 0, grade 1, and grade 2 were 5 (13.2%), 30(78.9%), and 3 (7.9%), respectively. The diameter of all AIS was 12 mm, which was as large as or larger than thediameter of the stent-graft distal limb. SMART stents were preferred in 34 limbs (89.5%) and stents with60-mm length were usually used (89.5%). During a mean follow-up of 9.13 ± 10.78 months, ischemic limb pain,which could be the sign of LO, was not noticed in any patients. There was no fracture, kinking, migration, in-stent restenosis, or occlusion of AIS.CONCLUSIONThe installation of AIS after extension of stent-graft to EIAreduced the risk of LO without any complications. AIS should be considered as a preventive procedure of LO ifstent-graft needs to be extended to EIA during EVAR.

23. Occlusion of the common and internal iliac arteries for aortoiliac aneurysm repair: experience with the Amplatzer vascularplug.Authors Grenon, S Marlene; Gagnon, Joel; Hsiang, York; Sidhu, Ravi; Taylor, David; Clement, Jason; Chen, JerrySource Canadian journal of surgery. Journal canadien de chirurgie; Dec 2009; vol. 52 (no. 6); p. E276Publication Date Dec 2009Publication Type(s) Journal ArticleDatabase Medline

Available in full text at Canadian Journal of Surgery from EBSCOhostAvailable in full text at Canadian Journal of Surgery from National Library of MedicineAvailable in full text at Canadian Journal of Surgery from ElsevierAvailable in full text at Canadian Journal of Surgery from ProQuestAvailable in full text at Canadian Journal of Surgery from EBSCOhost

Abstract BACKGROUNDWe sought to evaluate and describe our centre's experience with the Amplatzer vascular plug(AVP) for the occlusion of common and internal iliac arteries (CIA; IIA) during endovascular aortic aneurysmrepair (EVAR).METHODSWe performed a retrospective analysis of 20 consecutive patients between October2006 and December 2007, who underwent occlusion of the CIA or IIA before or during EVAR to preventendoleak.RESULTSAmong these 20 patients, 21 occlusion procedures occurred and 20 were successful. In theonly unsuccessful case, the patient had EVAR, but occlusion with an AVP was not possible because of severenarrowing at the origin of the vessel. Of the successfully treated patients, 2 presented with rupturedaneurysms, whereas the others had elective procedures. Eleven patients received aortouni-iliac grafts andfemoral-femoral bypass, and 9 patients received a bifurcated stent graft. In 5 patients, the AVP occlusion andEVAR procedures were staged; in these cases occlusion occurred first, followed by EVAR on average 29(standard deviation [SD] 23) days later. We deployed 7 AVPs in the CIA, whereas 13 were deployed in the IIA.The average diameter of the vessels occluded was 10 (SD 1) mm and the average size of the device used was 13(SD 1) mm, representing a device diameter 28% (SD 2%) greater than the vessel diameter. We used a singledevice in 18 patients, whereas 2 devices were deployed in the same artery in 2 patients. Four patientsunderwent concomitant coil embolization. On follow-up computed tomography (CT) scans, all occlusionprocedures were clinically successful. At the 14-month (SD 1 mo) follow-up, 4 patients had a small type-IIendoleak unrelated to the occlusion procedure and 1 had a type-I endoleak that required graft limb extension.Four patients had buttock claudication but none had changes in sexual function, ischemic complications ordevice dislodgement on CT scans.CONCLUSIONThe AVP is a safe and effective method to occlude the CIA andIIA in patients undergoing EVAR.

24. Management of acute type B aortic dissections and acute limb ischemia.Authors Khoynezhad, A; Rao, R; Trento, A; Gewertz, BSource The Journal of cardiovascular surgery; Aug 2011; vol. 52 (no. 4); p. 507-517Publication Date Aug 2011Publication Type(s) Journal Article ReviewDatabase Medline


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http://linker.worldcat.org/?rft.institution_id=129905&spage=E276&pkgName=owh&issn=0008-428X&linkclass=to_article&jKey=1IS&issue=6&provider=EBSCOhost&date=2009-12&aulast=Grenon%2C+S+Marlene%3B+Gagnon%2C+Joel%3B+Hsiang%2C+York%3B+Sidhu%2C+Ravi%3B+Taylor%2C+David%3B+Clement%2C+Jason%3B+Chen%2C+Jerry&atitle=Occlusion+of+the+common+and+internal+iliac+arteries+for+aortoiliac+aneurysm+repair%3A+experience+with+the+Amplatzer+vascular+plug.&title=Canadian+Journal+of+Surgery&rft.content=fulltext%2Cprint&linkScheme=ebscoh&jHome=http%3A%2F%2Fsearch.ebscohost.com%2Fdirect.asp%3Fdb%3Dmnh%26jid%3D1IS%26scope%3Dsite&volume=52&dbKey=mnh&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=E276&pkgName=UKPMCFT&issn=0008-428X&linkclass=to_article&jKey=504&issue=6&provider=NLM&date=2009-12&aulast=Grenon%2C+S+Marlene%3B+Gagnon%2C+Joel%3B+Hsiang%2C+York%3B+Sidhu%2C+Ravi%3B+Taylor%2C+David%3B+Clement%2C+Jason%3B+Chen%2C+Jerry&atitle=Occlusion+of+the+common+and+internal+iliac+arteries+for+aortoiliac+aneurysm+repair%3A+experience+with+the+Amplatzer+vascular+plug.&title=Canadian+Journal+of+Surgery&rft.content=fulltext%2Cprint&eissn=1488-2310&linkScheme=epmc&jHome=http%3A%2F%2Feuropepmc.org%2Fjournals%2F504&volume=52&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=E276&pkgName=ckjournalathens&issn=0008-428X&linkclass=to_article&jKey=0008428X&issue=6&provider=elsevier&date=2009-12&aulast=Grenon%2C+S+Marlene%3B+Gagnon%2C+Joel%3B+Hsiang%2C+York%3B+Sidhu%2C+Ravi%3B+Taylor%2C+David%3B+Clement%2C+Jason%3B+Chen%2C+Jerry&atitle=Occlusion+of+the+common+and+internal+iliac+arteries+for+aortoiliac+aneurysm+repair%3A+experience+with+the+Amplatzer+vascular+plug.&title=Canadian+Journal+of+Surgery&rft.content=fulltext%2Cprint&linkScheme=ckeyathens&jHome=https%3A%2F%2Fauth.elsevier.com%2FShibAuth%2FinstitutionLogin%3FentityID%3Dhttps%253A%252F%252Fidp.eduserv.org.uk%252Fopenathens%26appReturnURL%3Dhttps%253a%252f%252fwww.clinicalkey.com%252fdura%252fbrowse%252fjournalIssue%252f0008428X&volume=52&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=E276&pkgName=nhshospital&PQUEST.WAYFlessID=48078&issn=0008-428X&linkclass=to_article&jKey=41665&issue=6&provider=PQUEST&date=2009-12&aulast=Grenon%2C+S+Marlene%3B+Gagnon%2C+Joel%3B+Hsiang%2C+York%3B+Sidhu%2C+Ravi%3B+Taylor%2C+David%3B+Clement%2C+Jason%3B+Chen%2C+Jerry&atitle=Occlusion+of+the+common+and+internal+iliac+arteries+for+aortoiliac+aneurysm+repair%3A+experience+with+the+Amplatzer+vascular+plug.&title=Canadian+Journal+of+Surgery&rft.content=fulltext%2Cprint&linkScheme=pquest.athens&jHome=http%3A%2F%2Fsearch.proquest.com%2Fpublication%2F41665%2Fshibboleth%3Faccountid%3D48078&volume=52&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=E276&pkgName=mdc&issn=0008-428X&linkclass=to_article&jKey=1IS&issue=6&provider=EBSCOhost&date=2009-12&aulast=Grenon%2C+S+Marlene%3B+Gagnon%2C+Joel%3B+Hsiang%2C+York%3B+Sidhu%2C+Ravi%3B+Taylor%2C+David%3B+Clement%2C+Jason%3B+Chen%2C+Jerry&atitle=Occlusion+of+the+common+and+internal+iliac+arteries+for+aortoiliac+aneurysm+repair%3A+experience+with+the+Amplatzer+vascular+plug.&title=Canadian+Journal+of+Surgery&rft.content=fulltext%2Cprint&linkScheme=ebscoh&jHome=http%3A%2F%2Fsearch.ebscohost.com%2Fdirect.asp%3Fdb%3Dmdc%26jid%3D1IS%26scope%3Dsite&volume=52&dbKey=mdc&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=best

Abstract AIMThe aim of this study was to review the management of acute type B aortic dissection (TBAD) with acutelimb ischemia. A search using the "Pubmed" resulted in 254 records by combining the Medical Subject Headingkeywords (listed separately). The articles were assessed for their validity, correct pathology and patient cohort.Inclusion criteria included all patients with complicated acute TBAD who were candidates for open of thoracicendovascular aortic repair (TEVAR). The exclusion criteria included type A, asymptomatic acute or chronicTBAD, penetrating ulcer or intramural hematoma. TBAD with limb ischemia has a poor prognosis if notdiagnosed, triaged and treated promptly. Clinical presentation and diagnostic strategy as well as variousimaging are reviewed. Early mortality rate for complicated acute TBAD (with malperfusion to lower extremity)is 12%. The management has moved from open operation to primary TEVAR. In cases with anatomicobstruction, open surgical techniques such as femoral-femoral bypass, axillo-femoral bypass or surgicalfenestration can be successful in relief of malperfusion to the affected limb. One-year-survival rates are 85%. Acomplete to partial reverse aortic remodeling occurred in 78% of survivors of acute TBAD, if primary TEVAR isapplied. Acute TBAD with limb ischemia remains a clinical challenge that requires prompt diagnosis andtreatment. TEVAR of acute TBAD is associated with relatively low morbidity and mortality, and is more oftenused as primary approach for patients with limb ischemia. The outcomes with TEVAR compare favorably to theopen repair, and initiate reverse aortic remodeling in majority of the survivors.

25. Current evidence regarding chimney graft occlusions in the endovascular treatment of pararenal aortic pathologies: asystematic review with pooled data analysis.Authors Usai, Marco V; Torsello, Giovanni; Donas, Konstantinos PSource Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists; Jun

2015; vol. 22 (no. 3); p. 396-400Publication Date Jun 2015Publication Type(s) Meta-analysis Journal Article ReviewDatabase MedlineAbstract PURPOSETo review the literature on pararenal endovascular aneurysm repair (EVAR) to determine the

frequency and clinical relevance of chimney graft occlusions.METHODSA comprehensive search of the English-language literature abstracted in the Medline and the Cochrane Library databases was performed to identifycase series involving pararenal aortic pathologies (degenerative aneurysms, penetrating atherosclerotic ulcers,type Ia endoleaks, and para-anastomotic aneurysms) treated with EVAR and chimney grafts; thoracoabdominal,iliac, or aortic arch chimney graft placements were excluded, as were case reports in which the total number ofchimney grafts implanted at the reporting center could not be determined. The literature search identified 83studies regarding chimneys/snorkels for pararenal pathologies published between January 2007 and March2014. Of these, 7 studies met the inclusion criteria and were included in the analysis.RESULTSThere were 15(4.5%) occlusions in the overall 334 renovisceral vessels in which chimney grafts were deployed. The mean timeto chimney graft occlusion was 3.5 months (range 1-270 days) over a mean follow-up of 1.4 months (range9-24). The target arteries were the renal artery (n=12) and the superior mesenteric artery (SMA; n=3). Sevenpatients were asymptomatic, and no description was given in 5 cases. In the other 3 patients, the symptomswere acute renal failure, intestinal ischemia, and malignant hypertension. The treatment strategy included openconversion and iliorenal bypass (n=1), exploratory laparotomy to revascularize the SMA (n=1), hemodialysis(n=1), placement of bare metal stents (n=4), conservative treatment (n=2), and unknown (n=6). One (6.7%)patient died (an occluded SMA). Two patients with renal chimney occlusion suffered from temporary renalfunction deterioration.CONCLUSIONThe present analysis identified a low rate of chimney graft occlusions,which appear to occur generally a few months after placement. Involvement of the renal artery had no severeclinical consequences, while occlusion of the SMA can be associated with life-threatening complications. Moredetailed information regarding occluded chimney grafts will be needed in future publications to help identifythe causes.

26. Strategies that minimize the risk of iliac limb occlusion after EVAR.Authors Wu, Michael S H; Boyle, Jonathan RSource Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists; Feb

2012; vol. 19 (no. 1); p. 86-87Publication Date Feb 2012Publication Type(s) Journal Article CommentDatabase Medline


27. [Lower body ischemia due to bending of the stent after hybrid treatment for chronic stanford type B aortic dissection].Authors Nakao, Mitsutaka; Yamashiro, Masahito; Matsumura, Yoko; Yoshitake, Michio; Tanaka, Kei; Sakamoto,

Yoshimasa; Hashimoto, KazuhiroSource Kyobu geka. The Japanese journal of thoracic surgery; Aug 2013; vol. 66 (no. 9); p. 791-794


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http://linker.worldcat.org/?rft.institution_id=129905&spage=86&pkgName=nhshospital&PQUEST.WAYFlessID=48078&issn=1526-6028&linkclass=to_article&jKey=44248&issue=1&provider=PQUEST&date=2012-02&aulast=Wu%2C+Michael+S+H%3B+Boyle%2C+Jonathan+R&atitle=Strategies+that+minimize+the+risk+of+iliac+limb+occlusion+after+EVAR.&title=Journal+of+Endovascular+Therapy&rft.content=fulltext%2Cprint&linkScheme=pquest.athens&jHome=http%3A%2F%2Fsearch.proquest.com%2Fpublication%2F44248%2Fshibboleth%3Faccountid%3D48078&volume=19&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=86&pkgName=mdc&issn=1526-6028&linkclass=to_article&jKey=IR3&issue=1&provider=EBSCOhost&date=2012-02&aulast=Wu%2C+Michael+S+H%3B+Boyle%2C+Jonathan+R&atitle=Strategies+that+minimize+the+risk+of+iliac+limb+occlusion+after+EVAR.&title=Journal+of+Endovascular+Therapy&rft.content=fulltext%2Cprint&linkScheme=ebscoh&jHome=http%3A%2F%2Fsearch.ebscohost.com%2Fdirect.asp%3Fdb%3Dmdc%26jid%3DIR3%26scope%3Dsite&volume=19&dbKey=mdc&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=86&pkgName=owh&issn=1526-6028&linkclass=to_article&jKey=IR3&issue=1&provider=EBSCOhost&date=2012-02&aulast=Wu%2C+Michael+S+H%3B+Boyle%2C+Jonathan+R&atitle=Strategies+that+minimize+the+risk+of+iliac+limb+occlusion+after+EVAR.&title=Journal+of+Endovascular+Therapy&rft.content=fulltext%2Cprint&linkScheme=ebscoh&jHome=http%3A%2F%2Fsearch.ebscohost.com%2Fdirect.asp%3Fdb%3Dmnh%26jid%3DIR3%26scope%3Dsite&volume=19&dbKey=mnh&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=best

Publication Date Aug 2013Publication Type(s) Case Reports English Abstract Journal ArticleDatabase MedlineAbstract Lower body ischemia due to bending of a stented graft at the thoracic aorta was rare, particularly when it

occurred in several days after surgery. We experienced this complication and performed the 3rd-time thoracicendovascular repair( TEVAR).A 49-year-old man with a chronic aortic dissection of Stanford type B underwentTEVER;however we failed to close the entry because of the tortuously bended distal arch of the aorta. Then itwas decided the patient undergo a hybrid treatment with arch replacement and frozen elephant trunk.Seventeen days after the surgery, the blood pressure of the patient's lower limb was reduced rapidly and hisrenal function deteriorated. Bending of the stent was revealed by computed tomography( CT). The patientunderwent the 3rd-time emergency TEVAR, and his symptoms improved.

28. Response to letter to the editor: 'Re: Endograft limb occlusion in EVAR: iliac tortuosity quantified by three different indiceson the basis of pre-operative CTA'.Authors Taudorf, M; Schroeder, T V; Lönn, LSource European journal of vascular and endovascular surgery : the official journal of the European Society for

Vascular Surgery; Dec 2014; vol. 48 (no. 6); p. 712Publication Date Dec 2014Publication Type(s) Letter CommentDatabase Medline


29. Commentary on: "endograft limb occlusion in EVAR: iliac tortuosity quantified by three different indices on the basis ofpreoperative CTA".Authors Rancic, ZSource European journal of vascular and endovascular surgery : the official journal of the European Society for

Vascular Surgery; Nov 2014; vol. 48 (no. 5); p. 534-535Publication Date Nov 2014Publication Type(s) Journal Article CommentDatabase Medline


30. Re. 'Endograft limb occlusion in EVAR: iliac tortuosity quantified by three different indices on the basis of pre-operativeCTA'.Authors Lau, Y-F; Senaratne, J; Ghatwary, TSource European journal of vascular and endovascular surgery : the official journal of the European Society for

Vascular Surgery; Dec 2014; vol. 48 (no. 6); p. 711-712Publication Date Dec 2014Publication Type(s) Letter CommentDatabase Medline


31. Successful endovascular repair in two cases of graft limb occlusion after endovascular aneurysm repair for abdominal aorticaneurysms.Authors Hoshina, Katsuyuki; Kato, Masaaki; Mikuriya, Akiyoshi; Ohkubo, NobukazuSource Surgery today; May 2010; vol. 40 (no. 5); p. 487-490Publication Date May 2010Publication Type(s) Case Reports Journal ArticleDatabase Medline

Available in full text at Surgery Today from EBSCOhostAbstract Among 148 abdominal aortic aneurysm patients who underwent endovascular aneurysm repair at our

institution, two cases of graft limb occlusion (GLO) were identified and successfully treated with endovascularrepair. Guidewire cannulation against the occluded limb is the most important aspect of the procedure. After athrombectomy, balloon dilatation is performed followed by stent-graft deployment. Various procedures such asthrombectomy, thrombolysis, and extra-anatomical bypass have been adopted for the treatment of GLO. Ouruse of endovascular techniques, including overlapping stent grafts, has some benefits, namely, better patency ofanatomical route revascularization, decreased risk of ipsilateral shower embolization due to the stent graft'ssealing over the irregular remnant thrombus, and easy access to angioplasty for tortured iliac arteries.However, shower embolization during catheter handling or future fabric failure due to friction is the potentialcomplication associated with endovascular techniques. Intravascular repair techniques and stentgraft useshould therefore be an early step of the GLO treatment algorithm.


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http://linker.worldcat.org/?rft.institution_id=129905&spage=712&pkgName=ckjournalathens&issn=1078-5884&linkclass=to_article&jKey=10785884&issue=6&provider=elsevier&date=2014-12&aulast=Taudorf%2C+M%3B+Schroeder%2C+T+V%3B+L%C3%83%C2%B6nn%2C+L&atitle=Response+to+letter+to+the+editor%3A+%27Re%3A+Endograft+limb+occlusion+in+EVAR%3A+iliac+tortuosity+quantified+by+three+different+indices+on+the+basis+of+pre-operative+CTA%27.&title=European+Journal+of+Vascular+and+Endovascular+Surgery&rft.content=fulltext%2Cprint&linkScheme=ckeyathens&jHome=https%3A%2F%2Fauth.elsevier.com%2FShibAuth%2FinstitutionLogin%3FentityID%3Dhttps%253A%252F%252Fidp.eduserv.org.uk%252Fopenathens%26appReturnURL%3Dhttps%253a%252f%252fwww.clinicalkey.com%252fdura%252fbrowse%252fjournalIssue%252f10785884&volume=48&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=534&pkgName=ckjournalathens&issn=1078-5884&linkclass=to_article&jKey=10785884&issue=5&provider=elsevier&date=2014-11&aulast=Rancic%2C+Z&atitle=Commentary+on%3A+%22endograft+limb+occlusion+in+EVAR%3A+iliac+tortuosity+quantified+by+three+different+indices+on+the+basis+of+preoperative+CTA%22.&title=European+Journal+of+Vascular+and+Endovascular+Surgery&rft.content=fulltext%2Cprint&linkScheme=ckeyathens&jHome=https%3A%2F%2Fauth.elsevier.com%2FShibAuth%2FinstitutionLogin%3FentityID%3Dhttps%253A%252F%252Fidp.eduserv.org.uk%252Fopenathens%26appReturnURL%3Dhttps%253a%252f%252fwww.clinicalkey.com%252fdura%252fbrowse%252fjournalIssue%252f10785884&volume=48&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=711&pkgName=ckjournalathens&issn=1078-5884&linkclass=to_article&jKey=10785884&issue=6&provider=elsevier&date=2014-12&aulast=Lau%2C+Y-F%3B+Senaratne%2C+J%3B+Ghatwary%2C+T&atitle=Re.+%27Endograft+limb+occlusion+in+EVAR%3A+iliac+tortuosity+quantified+by+three+different+indices+on+the+basis+of+pre-operative+CTA%27.&title=European+Journal+of+Vascular+and+Endovascular+Surgery&rft.content=fulltext%2Cprint&linkScheme=ckeyathens&jHome=https%3A%2F%2Fauth.elsevier.com%2FShibAuth%2FinstitutionLogin%3FentityID%3Dhttps%253A%252F%252Fidp.eduserv.org.uk%252Fopenathens%26appReturnURL%3Dhttps%253a%252f%252fwww.clinicalkey.com%252fdura%252fbrowse%252fjournalIssue%252f10785884&volume=48&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=487&pkgName=mdc&issn=0941-1291&linkclass=to_article&jKey=O1K&issue=5&provider=EBSCOhost&date=2010-05&aulast=Hoshina%2C+Katsuyuki%3B+Kato%2C+Masaaki%3B+Mikuriya%2C+Akiyoshi%3B+Ohkubo%2C+Nobukazu&atitle=Successful+endovascular+repair+in+two+cases+of+graft+limb+occlusion+after+endovascular+aneurysm+repair+for+abdominal+aortic+aneurysms.&title=Surgery+Today&rft.content=fulltext%2Cprint&linkScheme=ebscoh&jHome=http%3A%2F%2Fsearch.ebscohost.com%2Fdirect.asp%3Fdb%3Dmdc%26jid%3DO1K%26scope%3Dsite&volume=40&dbKey=mdc&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=best

32. Adjunctive primary stenting of Zenith endograft limbs during endovascular abdominal aortic aneurysm repair: implicationsfor limb patency.Authors Sivamurthy, Nayan; Schneider, Darren B; Reilly, Linda M; Rapp, Joseph H; Skovobogatyy, Herman; Chuter,

Timothy A MSource Journal of vascular surgery; Apr 2006; vol. 43 (no. 4); p. 662-670Publication Date Apr 2006Publication Type(s) Research Support, Non-u.s. Gov't Comparative Study Journal ArticleDatabase Medline

Available in full text at Journal of Vascular Surgery from Free Access ContentAbstract OBJECTIVEEndograft limb occlusion is an infrequent but serious complication of endovascular abdominal

aortic aneurysm (AAA) repair. The insertion of additional stents within the endograft limb may prevent futureocclusion. This study evaluates limb patency with and without adjunctive stenting of endograft limbs at the timeof endovascular AAA repair.METHODSWe performed a retrospective review of 248 patients who underwentendovascular abdominal aortic aneurysm repair with the Zenith AAA endovascular graft between 1999 and2004. Among these patients, two groups were identified: 64 patients with adjunctive stents placed in 85 limbsand 184 patients without additional bare stent placement in endograft limbs at the time of endovascular AAArepair.RESULTSWomen comprised 23% of stented and 11% of unstented patients (P = .02). The mean length offollow-up in the stented and unstented groups was 2.0 years. There were 13 instances of limb thrombosis in 13patients (5.2% of patients, 2.7% of limbs), all in the unstented group. No limb occlusions occurred in thepresence of adjunctive bare metal stents. Seventy-three percent of the occlusions occurred < or = 6 months ofendovascular AAA repair. Two patients (15%) had no symptoms of lower-extremity ischemia despite graft limbocclusion and did not undergo intervention. The others underwent thrombectomy (n = 2), thrombectomy withbare stent placement (n = 3), femoral-femoral bypass (n = 4), thrombolysis (n = 1), and thrombolysis with barestent placement (n = 1). Of the seven who underwent thrombectomy or thrombolysis, three had no additionalstents placed at the secondary procedure, and two of these three went on to rethrombose. By life-tableanalysis, primary patency at 3 years in the stented and nonstented limbs was 100% +/- 0% and 94% +/- 3%,respectively (P = .05).CONCLUSIONSThe intraoperative insertion of additional bare metal stents appeared toeliminate the risk of thrombosis and was without complication. Of the 85 stented limbs in this series, not oneoccluded. The overall rate of limb thrombosis was low, with most limb occlusions occurring < or = 6 months ofstent-graft insertion, and would probably have been even lower had we been able to identify all high-risk casesfor prophylactic adjunctive stenting. Limb occlusion denotes an underlying problem with the graft, which if leftuntreated after thrombectomy or thrombolysis will lead to rethrombosis. Postoperative imaging was of littlevalue in detecting impending limb occlusion. Based on these findings, we believe one should identify and stentany limbs that appear to be at risk for thrombosis, but this study lacks the data to predict which limbs needstenting.

33. Successful Endovascular Management of Intraoperative Graft Limb Occlusion and Iliac Artery Rupture Occurred duringEndovascular Abdominal Aortic Aneurysm Repair.Authors Lim, Jae Hong; Sung, Yong Won; Oh, Se Jin; Moon, Hyeon Jong; Lee, Jeong Sang; Choi, Jae-SungSource The Korean journal of thoracic and cardiovascular surgery; Feb 2014; vol. 47 (no. 1); p. 71-74Publication Date Feb 2014Publication Type(s) Journal ArticleDatabase Medline

Available in full text at Korean Journal of Thoracic and Cardiovascular Surgery, The from National Library ofMedicineAvailable in full text at Korean Journal of Thoracic and Cardiovascular Surgery, The from National Library ofMedicineAvailable in full text at Korean Journal of Thoracic and Cardiovascular Surgery, The from National Library ofMedicine

Abstract For high-risk patients, endovascular aortic aneurysm repair (EVAR) is a good option but may lead to seriouscomplications, which should be addressed immediately. A 75-year-old man with a history of abdominal surgeryunderwent EVAR for an aneurysm of the abdominal aorta and iliac arteries. During EVAR, iliac artery ruptureand graft limb occlusion occurred, and they were successfully managed by the additional deployment of an iliacstent graft and balloon thrombectomy, respectively. We, herein, report a rare case of the simultaneousdevelopment of the two fatal complications treated by the endovascular technique.

34. Type B aortic dissection after endovascular abdominal aortic aneurysm repair causing endograft collapse and severemalperfusion.Authors Iyer, Vikram; Rigby, Mark; Vrabec, GeorgeSource Journal of vascular surgery; Aug 2009; vol. 50 (no. 2); p. 413-416Publication Date Aug 2009Publication Type(s) Case Reports Journal ArticleDatabase Medline


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http://linker.worldcat.org/?jHome=http%3A%2F%2Fwww.sciencedirect.com%2Fscience%2Fjournal%2F07415214&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=71&pkgName=PubMedCentralFT&issn=2233-601X&linkclass=to_article&jKey=101563922&issue=1&provider=NLM&date=2014-02&aulast=Lim%2C+Jae+Hong%3B+Sung%2C+Yong+Won%3B+Oh%2C+Se+Jin%3B+Moon%2C+Hyeon+Jong%3B+Lee%2C+Jeong+Sang%3B+Choi%2C+Jae-Sung&atitle=Successful+Endovascular+Management+of+Intraoperative+Graft+Limb+Occlusion+and+Iliac+Artery+Rupture+Occurred+during+Endovascular+Abdominal+Aortic+Aneurysm+Repair.&title=Korean+Journal+of+Thoracic+and+Cardiovascular+Surgery%2C+The&rft.content=fulltext%2Cprint&eissn=2093-6516&linkScheme=pmc&jHome=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Fjournals%2F1683&volume=47&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=71&pkgName=PubMedCentral&issn=2233-601X&linkclass=to_article&jKey=101563922&issue=1&provider=NLM&date=2014-02&aulast=Lim%2C+Jae+Hong%3B+Sung%2C+Yong+Won%3B+Oh%2C+Se+Jin%3B+Moon%2C+Hyeon+Jong%3B+Lee%2C+Jeong+Sang%3B+Choi%2C+Jae-Sung&atitle=Successful+Endovascular+Management+of+Intraoperative+Graft+Limb+Occlusion+and+Iliac+Artery+Rupture+Occurred+during+Endovascular+Abdominal+Aortic+Aneurysm+Repair.&title=Korean+Journal+of+Thoracic+and+Cardiovascular+Surgery%2C+The&rft.content=fulltext%2Cprint&eissn=2093-6516&linkScheme=pmc&jHome=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Fjournals%2F1683&volume=47&rft.id=info%3Apmid%2F&rft.order_by=preference&linktype=besthttp://linker.worldcat.org/?rft.institution_id=129905&spage=71&pkgName=UKPMCFT&issn=2233-601X&linkclass=to_article&jKey=1755&issue=1&provider=NLM&date=2014-02&aulast=Lim%2C+Jae+Hong%3B+Sung%2C+Yong+Won%3B+Oh%2C+Se+Jin%3B+Moon%2C+Hyeon+Jong%3B+Lee%2C+Jeong+Sang%3B+Choi%2C+Jae-Sung&atitle=Successful+Endovascular+Management+of+Intraoperative+Graft+Limb+Occlusion

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